MRI对评估腰椎间盘退变程度的临床意义

摘要

Objective To investigate the correlation of severity of lumbar disc degeneration lumbar disc and MRI performance. Methods 56 patients with lumbar disc degeneration in our hospital were enrolled in this study. MRI was performed on 56 patients,postoperative nucleus pulposus component were analysed,the correlation analysis and nucleus pulposus signal strength(RSI)and nucleus pulposus ingredients change were also anaylsed . Results 0 cases of grade 0 patients in this study,eight cases of patients with grade I,19 patients in grade II in,grade III had 29 patients. RSI of grade II patients had significant difference than grade I(P<0.05),RSI of gradeⅢpatients had significant difference than grade I, II(P<0.05). Water content of gradeⅢpatients had significant difference than grade I(P<0.05),water content of grade II patients had no significant difference than grade I(P>.05),chondroitin sulfate content of grade II patients had significant difference than grade I(P<0.05),gradeⅢ patients had significant difference than grade I,II(P<0.05).Keratan sulfate gradeⅢpatients had significant difference than grade I(P<0.05).After RSI and moisture content,chondroitin sulfate,keratan sulfate content correlation analysis,the RSI and moisture content,chondroitin sulfate content showed a significant positive correlation(P<0.05),the RSI with sulfuric keratin content showed no currently significant differences. Conclusion MRI nucleus pulposus signal strength can better reflect the nucleus pulposus moisture content and the nucleus pulposus changes in the composition,RSI grading degeneration may be a better response to the nucleus pulposus.%　　目的探讨腰椎间盘退变程度与MRI表现的相关性。方法对临床诊断腰椎间盘退变的56例患者作MRI检查，术后对切除髓核标本作成分测定，并对MRI检查髓核信号强度（RSI）与髓核成分改变进行相关性分析。结果腰椎间盘退变0级0例，I级8例，Ⅱ级19例，Ⅲ级29例。Ⅲ级水分含量较I级差异有统计学意义（P<0.05），II级水分含量较I级有下降，但差异无统计学意义（P>0.05）。II级硫酸软骨素含量较I级下降（P<0.05），Ⅲ级又较II级下降（P<0.05）。RSI与水分含量、硫酸软骨素含量呈正相关（P<0.05），与硫酸角质素含量无相关性。结论 MRI的RSI能较好反映髓核水分含量及髓核主要成分，从而能较好判断腰椎间盘髓核的退变程度。